الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Intraocular pressure (IOP) is the fluid pressure in the eye mainly related
to aqueous humor which is secreted by the ciliary process to the posterior
chamber and goes through the pupil to the anterior chamber (inflow). It then
leaves the anterior chamber through the trabecular meshwork to the venous
system (outflow). Normally, there is equilibrium between inflow and outflow
that creates normal intraocular pressure (IOP).
The measurement of intraocular pressure (IOP) is an essential
examination in daily ophthalmic procedures, also is a fundamental tool in the
management and follow-up of glaucoma patients. Many factors, such as central
corneal thickness (CCT), corneal astigmatism and biomechanical properties of
the cornea can affect the accuracy of IOP measurement.
Elevated intraocular pressure (IOP) is a major risk factor for the
development and progression of glaucoma. Therefore, IOP measurements
provide important information to clinicians about glaucoma diagnosis, assessing
the possibility of progression, and monitoring the clinical response to therapy.
Goldmann applanation tonometry (GAT) is considered as a worldwide
accepted gold standard for IOP measurement in clinical practice. Recently,
several new methods have been devised, in order to make the IOP measurement
faster and more comfortable.
Another applanation device is a non-contact tonometer (NCT; Nidek Co.,
Ltd., Aichi, Japan), also called an Air-Puff tonometer. An NCT uses air to
flatten the cornea instead of touching it.
The iCare rebound tonometer (iCare, Helsinki, Finland) is a new
technique for IOP measurements. A very light probe is launched against the
corneal surface to make fleeting contact and spring back from the cornea. The
Summary and Conclusion
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deceleration of the probe is calculated into the IOP and displayed on the device
after six rebounds per measurement. Due to its comfortableness and ease of use,
iCare tonometer has gained much attention in clinical practice.
This study aimed to compare Intraocular pressure measurements using
three different tools, Goldmann Tonometer, Air-Puff Tonometer and iCare
Tonometer in normal subjects, glaucomatous patients and patients after
refractive surgery.
This cross-sectional study was conducted on 102 of the patients attending
the outpatient clinic of Ophthalmology department Menoufia University.
The cases were divided into three equal groups:
group I (control group): included normal subjects as a control
group.
group II (Glaucoma group): included glaucomatous patients on
medical treatment.
group III (Refractive group): included subjects after refractive
surgery.
Summary of our results:
No significant differences were found between all studied groups
regarding gender.
iCare Tonometer was significantly lower in Lasik when compared to
control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides.
Air-Puff Tonometer was significantly lower in Lasik when compared to
control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides.
Summary and Conclusion
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Goldmann Tonometer was significantly lower in Lasik when compared to
control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides.
IOP was measured by different methods. It was noticed that Goldmann
had lower measures in the three groups.
IOP measures by Goldmann Tonometer and iCare Tonometer did not
differ significantly among all studied groups. IOP measures by iCare
Tonometer and Air-Puff Tonometer did not differ significantly among all
studied groups.
IOP measures by Goldmann Tonometer and Air-Puff Tonometer differed
significantly among all studied groups.
Mean differences in IOP between Air-Puff and Goldmann Tonometers
was 2.6, while it was 1.12 between iCare and Goldmann Tonometer and
1.5 between iCare and Air-Puff Tonometer.
Inter class correlation between all studied methods was strong.
CCT was significantly lower in Lasik when compared to control
(p3<0.05) and glaucoma (p4<0.05) groups on right and left sides.
CCT showed significant positive correlations with age, IOP by iCare
Tonometer, Air-Puff Tonometer, Goldmann Tonometer.